Annali dell'Istituto Superiore di Sanità
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Health and Climate Change: science calls for global action
Get PDFClimate changes affect social and environmental health determinants such as clean air, ecosystems health, safe drinking water and safe sufficient food. Globally, people at greatest risk of adverse health effects associated with climate change include children, the elderly and other vulnerable groups. Temperature-related death and illness, extreme events, polluted or stressed ecosystems represent relevant issues raising concern for both health and economic consequences. The aim of the Symposium was to promote an inter-sectoral and multidisciplinary approach to estimate, and to prevent, climate change-related events as well as to call the authorities to put in place measures to reduce adverse health effects.At the end of the Symposium the Rome International Charter on Health and Climate Change was presented. It includes a series of actions and recommendations, discussed and shared by all the participants, intended to inform policy makers and all the stakeholders involved in the management of climate changes
Identikit of Umbrian traveller: analysis of clinical activity in a travel medicine unit, Italy
Get PDFTravel medicine clinic is the proper medical centre aimed to provide updated recommendations before the journey. We analysed Travel Medicine Clinic of the Local Health Unit in Umbria region data. Study aim was to assess the number of accesses done during 2016. Demographics characteristics, travel and health information were collected. An electronic ad hoc database was developed. Data paper-based referring to 2016 were recorded in this electronic registry, developed on Microsoft Office Access®. Statistical analysis was performed using STATA SE/12®. In 2016, 891 subjects came in our clinic in order to get information before travel. In our sample, 53.3% were male and the mean age was 35.33 years ± 0.58. Almost half were high educated. Twenty percent of the people were foreign. Vaccines against food-and waterborne diseases were the most frequently administered. Approximately, in 74% of the attenders we suggested an anti-malaria prophylaxis (Mefloquine in one-half, approximately). Every traveller received a pre-travel counselling. Sociodemographic characteristics of Umbrian travellers, information about destinations and type of journeys are presented in this paper. Performance activity of our clinic and the adherence to preventive protocol in case of international travels, have been assessed
Detection of tick-borne pathogens in ticks collected in the suburban area of Monte Romano, Lazio Region, Central Italy
Get PDFBackground. A study on tick species characterization and tick borne pathogens detection was performed within a survey conducted during 2012 and 2013 in the Viterbo province (Lazio Region, Central Italy). Seven sites were selected for the study investigation, including two farms and a military zone. Methods. A total of 255 ticks, Rhipicephalus (Boophilus) annulatus (n =215), Rhipicephalus bursa (n = 28), and Hyalomma marginatum (n = 12) were screened individually by molecular methods for the tick borne bacterial agents: Borrelia burgdorferi sensu lato group, Bartonella spp., Coxiella burnetii, Ehrlichia spp., Francisella spp., and Rickettsia spp. Results and Conclusion. Overall, 182 ticks (71%) were infected with one pathogen but co-infections were also found. Tick borne pathogens identified were C. burnetii, B. burgdorferi s.l.., Bartonella spp., Rickettsia spp., Francisella spp., and Ehrlichia spp. In R. bursa and H. marginatum, the presence of B. burgdorferi s.l. was positively correlated with that of C. burnetii, Rickettsia spp., and Bartonella spp. and their coinfection probabilities were 29.8%, 22.7% and 11.7%, respectively. The Probability of coinfection for Francisella spp. and Rickettsia spp. and for Francisella spp. and Bartonella spp. was 14.9% and 17.9%, respectively. In R. (Boophilus) annulatus, the probability of coinfection between C. burnetii and B. burgdorferi s.l. was 11.3%, while those between C. burnetii and Bartonella and between B. burgdorferi s.l. and Bartonella were 0.8%. Further studies are needed in order to assess the risk associated with these tick-borne pathogens, somewhat unusual in Central Italy
Estimated burden of Chlamydia trachomatis female infection and consequent severe pelvic inflammatory disease, Italy, 2005-2016
Get PDFChlamydia trachomatis (Ct) is the leading sexually transmitted infection (STI) across Europe. In Italy, prevalence is low in general population; anyway, predominance of asymptomatic infections, passive voluntary reporting, variable diagnostic criteria and coding practices suggest for considerable underestimation, preventing assessment of real burden of disease and health intervention. We analysed data on female genital Ct infection registered in STI sentinel surveillance systems in Italy from 2005 through 2016 and found 3,305 women. Among them, those aged 20-24 years had the highest disability-adjusted life years (DALYs) estimation equal to 106.77 DALYs per 100,000-stratum specific population. Through the study period, incidence rate (IR) for female Ct infection increased significantly from 2.9 to 7.1 per 100,000 resident population. Besides, we analysed data on pelvic inflammatory disease (PID) sequela reported from the National Hospital Information system (NHIS) in the same period. We found 287 women hospitalised with concurrent PID and Ct infection. We recommend targeted screening programmes in women aged 20-24, definition of nationwide active surveillance system, standardisation of diagnostic criteria and ICD-9CM coding practices
Factors predicting health science students\u27 willingness to be vaccinated against seasonal flu during the next campaign
Get PDFIntroduction. Influenza is an infectious disease with a high burden, for which a safe and efficacy vaccine is available. However, vaccination coverage is generally low, also among Health Care Workers (HCW). Health Professions students are comparable to HCW in terms of workplace exposure. Aim. The study aim was to identify predictive factors of flu vaccination acceptance among Italian students of Health Professions. Methods. A cross-sectional study was performed using a validated, on-line, anonymous questionnaire. Data were analyzed performing both univariable and multivariable logistic analysis. Results. The results showed a statistically significant association between intention to vaccinate next year and: geographical distribution, considering themselves at higher risk due to their profession, having been vaccinated last year, having recommended the vaccination last year, and being willing to recommend it next year and being favorable to mandatory vaccination. In conclusion, identifying an effective vaccination strategy and including students in flu vaccination campaigns might have positive effect on vaccination acceptance.
Blood transfusions and adverse acute events: a retrospective study from 214 transfusion-dependent pediatric patients comparing transfused blood components by apheresis or by whole blood
Get PDFBlood transfusion is a lifesaving procedure for patients affected by hematological diseases or hemorrhage risk. This retrospective study was aimed to evaluate clinical safety of pediatric transfusions by comparing the frequency of adverse events caused by apheretic blood components vs whole blood. From 2011 to 2015, 214 patients (blood malignancy patients, n=144 and thalassemic patients, n=70) received 12,531 units of blood components. The adverse acute reactions occurred during patient hospitalization were reported to the Hemovigilance system and assessed by fitting a logistic mixed-effect model. A total of 33 (0.3%) patients showed adverse acute events. Odds ratio (OR) of adverse events from apheresis vs whole blood transfusion adjusted by patient classification was not statistically significant (OR [95% CI], 0.75 [0.23–2.47]). Our findings showed no significant differences in the prevalence of adverse acute events between blood component collected by apheresis vs whole blood in our study center
Policies and actions to tackle rare diseases at European level
Get PDF Rare diseases (RDs) are defined by the European Union as life-threatening or chronically debilitating conditions, with a prevalence lower than 5 per 10 000 inhabitants. Around 6000 diseases are described, affecting between 6% and 8% of the European population. Due to their severity, diffusion and multi-faceted aspects, RD are an area where collaboration in public health, health care and research provides a major integrated added value. Main areas for policy actions include: the development and implementation of European Reference Networks, as a main strategy for sharing of knowledge, clinical expertise and foster research; integration of high-quality patient registries, biobanks, and bioinformatics support, as key infrastructure tools addressing research and healthcare needs; the implementation of National Plans on RD in EU Member States by sharing experiences, capacity building and linking national efforts through a common strategy at a European level; actions driven by the recommendations for primary prevention of congenital anomalies (the main RD group with multifactorial aetiology); policy provisions to fosterresearch and development of orphan drugs.
Refinement techniques in non-human primate neuroscientific research
Get PDFNon-human primates (NHP) are widely considered an essential model for biomedicalresearch because of their close genetic, anatomo-functional and cognitive similarities tohumans. These same reasons also raise particular ethical concerns for the unavoidableharm caused to these animals, in particular to those involved in neuroscientific studies.Besides reducing the number of animals needed to the absolute minimum, it is thereforeessential to implement procedures allowing, at the same time, to minimize the harm tothe animals and maximize the quality and ecological validity of the data. Technologicalprogresses have made possible, for example, to self-train monkeys in their home cagewith positive reinforcement techniques and to adopt various types of telemetric systemsfor wirelessly recording neuronal activity in freely behaving animals. Example of full applicationof these techniques are still very limited in the literature, but different recentinternational projects and pioneering studies are paving the way for turning to the useof new technologies to get a more “ethically acceptable” NHP neuroscientific research
iGeneration’s Social media usage in retrieving information related to healthcare education: a web-based survey among Italian and Romanian undergraduate medical students
Get PDFThe aim of our study was to assess medical undergraduate student’s preferences associated with the value of information/learning methods via social media. An electronic questionnaire was developed and applied to medical undergraduate students from two university centers: Foggia (Italy) and Cluj-Napoca (Romania). One thousand one hundred ninety-six answers were collected, 326 from the Italian university, and 870 from the Romanian university. Students use smartphones to access Facebook, from home, in average 1-3 hours daily. Along with school bibliography and Internet, social media is an active part of the academic life of students. Social media is used to search information about a specific medical topic or to manage of daily student activities. Romanians frequently share information with other colleagues or search for topics related to courses taught at school. The medical students use social media for academic purposes similarly in Italy and Romania